Sixteen cases of uveitis associated with sarcoidosis

Abstract

In 210 cases of uveitis sixteen were associated with sarcoidosis. All patients had bilateral involvement and thirteen patients had a panuveitis. Ophthalmic and systemic findings in these patients are described and compared with the literature. Nine patients were not known to have sarcoidosis previously; seven of these presented with the typical signs for sarcoidosis, such as periphlebitis with 'candle wax' exudates and/or small chorioretinal lesions.

Visual loss in sarcoid‐related uveitis

“…It is not possible therefore to determine the frequency of different types of uveitis in sarcoid patients as a whole from this study. A higher incidence of posterior disease has been noted in previous European studies 3,11 , when compared with the US series; however, this difference has been attributed to differing racial profiles, with US studies tending to comprise higher proportions of black patients than European studies, while posterior segment disease has been reported more frequently in white patients 3 . In this series it was not possible to identify the race of all patients from the hospital records but anterior uveitis did appear to be relatively evenly distributed between white (30.6%) and black (33.3%) patients.…”

“…Chorioretinitis in association with sarcoidosis was described as long ago as 1925 16 , and generally occurs with anterior uveitis and vitritis, although isolated choroidal lesions do occur 17 . Bienfait and Baarsma noted multiple focal chorioretinal lesions in six of 16 patients with sarcoid uveitis, three of whom developed macular oedema, one artery occlusion, one vitreous haemorrhage and all six of whom had a poor visual outcome 11 . Spalton et al.…”

Risk factors for ocular sarcoidosis

“…In only one of the 10 white sarcoidosis patients with uveitis was the inflammation limited to the anterior segment. This high frequency of posterior segment involvement in European patients had already been noted [1]. The important difference between European and American studies lies in the number of black and white patients studied.…”

“…In the studies from the United States, black patients represent the largest proportion of the total [3,6,14]. European studies usually involve only white patients [2,10], or the patient's race is not specified [1,7]. This study from the University Hospital of Amsterdam covers a mixed racial population and shows that different types of uveitis are seen in white and black patients.…”

“…The reported incidence of sarcoidosis in a uveitis population is about 3-8% [1,5,8,12,19]. These figures depend largely on the nature of the tests performed and the follow-up laboratory and radiologic examinations.…”